Jerseyville Pain Management Center, S.c.
NPI #1255609574 in Wood River, Illinois
Provider Information
- NPI Number
- 1255609574
- Entity Type
- Organization
- Organization Name
- Jerseyville Pain Management Center, S.c.
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- JERSEYVILLE PAIN MANAGEMENT CENTER, S.C.
- Primary Specialty
- Non-Pharmacy Dispensing Site
- Enumeration Date
- Dec 1, 2011
- Last Updated
- Jan 3, 2012
Practice Location
- Address
- 1702 VAUGHN RD
- City
- Wood River
- State
- Illinois
- ZIP Code
- 62095-1898
- Phone
- (618) 259-3321
Authorized Official
- Name
- DR. BUD CHOMHIRUN, M.D.
- Title
- MEDICAL DIRECTOR
- Phone
- (618) 259-3321
Specialties & Taxonomy Codes
| Specialty |
|---|
| Non-Pharmacy Dispensing Site |
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